Cancer patient Leisa Renwick was about to switch from one high-cost melanoma drug to another, but now new funding plans mean she can avoid the potential stress and uncertainty of the change.
Government medicines funding agency Pharmac announced last month it would pay for Opdivo to treat patients with advanced, inoperable melanoma from this Friday. Yesterday, it published a new provisional agreement to fund rival drug Keytruda from September 1 as part of a supply deal that also involves an HIV medication and anti-fungal drug.
Patients would be able to switch melanoma drugs within 12 weeks of starting if their first one was intolerable and their disease had not progressed.
Opdivo and Keytruda are in the new class of immunotherapies called PD-1 (programmed cell-death protein-1) inhibitors. Both are extending the lives of some patients and are very expensive.
New Zealand has the world's highest rate of melanoma, a disease readily treated by surgery if detected early but which has, prior to Opdivo, had no effective, state-funded treatments for those in whom it has spread. Melanoma kills about 350 Kiwis a year.
In May last year, Mrs Renwick was expected to soon die from melanoma that had spread. But her health improved on the drug dabrafenib and then with Keytruda infusions, which she was expecting to cost $300,000 for two years' treatment. Her disease is now in remission and she is back at work as a secondary school teacher.
Because of Opdivo's funding, the Tauranga woman had been considering switching to it. But now, thanks to a bridging programme started yesterday by Keytruda supplier Merck Sharp and Dohme, she plans not to change.
Merck NZ's director, Paul Smith, said he hoped Keytruda funding could start on September 1.
"In the meantime, MSD is providing a bridging programme for current melanoma patients on Keytruda and for melanoma patients who would like to start Keytruda treatment. The programme provides melanoma patients with two months' supply of Keytruda paid for by MSD.
"It means melanoma patients using Keytruda now can maintain their current treatment regime rather than go through the inconvenience and potential stress of switching medicine."
Mrs Renwick said that prior to yesterday's announcements, she had faced some confusion over whether she would switch to Opdivo and then back to Keytruda if it was funded by Pharmac. But now the decision was easier.
"I'm sticking with the one that is working for me now, the one I have got used to."
Cancer Society medical director Dr Christopher Jackson welcomed the proposed funding of a second immunotherapy for melanoma, but he was disappointed that hundreds of people who could have had their lives extended by the drugs had missed out because New Zealand did not have an early-access scheme to fund promising new cancer drugs.
He said there was little difference between the clinical trial results of the two melanoma drugs so there were no issues in switching.
Keytruda was quicker to infuse and given three-weekly as opposed to fortnightly for Opdivo, so there was less travel for patients and it was less resource-intense for clinics.